NPI | 1306038963 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW002653) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 280654-3501) |
Enumeration Date | 2007-08-16 |
Last Update Date | 2014-09-24 |